28D2177109 CLIA NUMBER - VITALIZE HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 28D2177109
  • Facility Name: VITALIZE HEALTH, LLC
  • Facility Address: 2200 S 40TH ST SUITE 102
    LINCOLN, NE
    ZIP 68506
  • Facility Phone: 402 413-0717
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE STEWART
  • NPI Number: 1710540307
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 28D2177109
LAB Type Physician Office
Facility Name VITALIZE HEALTH, LLC
Street 2200 S 40TH ST SUITE 102
City LINCOLN
State NE
ZIP 68506
Phone 402 413-0717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2024
Certificate Expiration Date 1/5/2026
Facility Type Physician Office
Lab Director JACQUELINE STEWART

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025